2 Common Mistakes In Workers’ Comp Doctor Selection

When a workplace injury occurs, selecting the right physician is a critical factor in ensuring a smooth recovery and return to work. However, employers frequently make two common mistakes when directing employees to medical care: blindly using the network and providing an invalid doctor list. These errors can have significant consequences, including prolonged recovery times, increased claims costs, and a greater likelihood of litigation.

Mistake #1: “Just Use the Network”

Employers often assume that simply referring an injured employee to any in-network provider is sufficient. While using an approved network is necessary for insurance and cost-control reasons, not all doctors within the network are equally effective at managing workplace injuries.

An ideal occupational health physician should:

• Have experience treating workplace injuries.
• Understand the employer’s work environment and physical job demands.
• Be committed to helping employees return to work safely and efficiently.
• Communicate proactively with the employer regarding the employee’s medical restrictions and expected recovery timeline.

When employers rely solely on network directories without vetting providers, they may inadvertently direct employees to doctors who lack familiarity with occupational medicine or who are indifferent to return-to-work strategies. This can lead to prolonged disability, unnecessary treatments, and frustration for both the employer and employee.

Solution: Employers should establish relationships with occupational health providers before an injury occurs. Ideally, the doctor should visit the workplace to gain firsthand knowledge of job roles and physical demands. This partnership fosters better communication, facilitates informed decision-making, and ensures injured employees receive care that aligns with business goals and regulatory requirements.

Mistake #2: Providing an Invalid Doctor List

A more severe mistake occurs when an employer hands an injured worker a list of doctors, only for the employee to discover that none of them are viable options. Consider the case of Jane, a worker who sustained a severe back injury. She was given a list of four medical providers but found that:

• Two providers did not accept workers’ compensation patients.
• One provider accepted workers’ compensation but was not taking new patients.
• The only available provider was 70 miles away.

Jane, already in pain and stressed about her recovery, was left with few good options. Her frustration led her to hire an attorney, which in turn increased claim costs and reduced her likelihood of returning to work.

Solution: Employers must routinely verify that the medical providers they recommend:

• Accept workers’ compensation cases.
• Are currently accepting new patients.
• Have availability for timely appointments.
• Are located within a reasonable distance from the workplace.

A best practice is to call each provider on the list at least quarterly to confirm their workers’ compensation policies and availability. Additionally, working with a third-party administrator (TPA) or managed care provider can help keep an updated, valid list of physicians.

The Impact of Proper Physician Selection

Investing time in selecting and maintaining relationships with qualified physicians pays off in several ways:

• Faster Recovery Times: Employees receive appropriate treatment, reducing unnecessary medical procedures and delays.
• Lower Claims Costs: Proactive physician involvement minimizes lost workdays and the risk of prolonged disability claims.
• Reduced Litigation: Employees who receive timely, quality care are less likely to feel neglected and seek legal representation.
• Improved Workplace Morale: A well-managed workers’ compensation process demonstrates that the company values its employees’ well-being.

Conclusion

Choosing the right medical provider for an injured employee is one of the most crucial steps in workers’ compensation management. Employers who move beyond the “just use the network” mentality and take proactive steps to validate provider availability can significantly improve injury outcomes. By fostering strong relationships with occupational health physicians and ensuring injured employees receive timely, competent care, businesses can reduce costs, minimize disruptions, and enhance their overall workplace safety culture.

Michael Stack, CEO of Amaxx LLC, is an expert in workers’ compensation cost containment systems and provides education, training, and consulting to help employers reduce their workers’ compensation costs by 20% to 50%. He is co-author of the #1 selling comprehensive training guide “Your Ultimate Guide to Mastering Workers’ Comp Costs: Reduce Costs 20% to 50%.” Stack is the creator of Injury Management Results (IMR) software and founder of Amaxx Workers’ Comp Training Center. WC Mastery Training teaching injury management best practices such as return to work, communication, claims best practices, medical management, and working with vendors. IMR software simplifies the implementation of these best practices for employers and ties results to a Critical Metrics Dashboard.

Contact: mstack@reduceyourworkerscomp.com.

Workers’ Comp Roundup Blog: http://blog.reduceyourworkerscomp.com/

Injury Management Results (IMR) Software: https://imrsoftware.com/

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